Spine
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: Long-term data are now available to support the safety and efficacy of lumbar total disc replacement (TDR). Five-year randomized and controlled trials, meta-analyses, and observational studies support a similar or lower risk of complications with lumbar TDR compared with fusion. ⋯ Survey results of surgeon practice experiences supported the evidence, revealing a low rate of complications with TDR. Panelists acknowledged the importance of adhering to selection criteria to help minimize patient complications.
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Multicenter Study
Minimal Clinically Important Difference in Quality of Life for Patients with Low Back Pain.
Multicenter, prospective, cohort study. ⋯ 2.
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Retrospective analysis of prospective data. ⋯ 2.
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: Consensus statements regarding the evidence-base for lumbar total disc replacement, as it pertains to payer decision-making, were developed through a modified-Delphi technique involving 17 spine surgeons and a former payer medical director. The Delphi process involved one round of anonymous survey and one round with a face-to-face meeting. The survey was a 51-item, electronically administered questionnaire to determine level of agreement with proposed statements on the evidence for lumbar total disc replacement and to provide additional diagnosis and management practice information for further deliberations. ⋯ The voting processes during meeting deliberations remained anonymous. Consensus was defined as ≥ 90% agreement. Consensus was reached on 11 statements, divided into themes that focused on patient eligibility and diagnosis, evidence criteria for coverage decisions, clinical evidence, and budgetary implications.
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A retrospective review of prospectively collected clinical and radiologic data of patients with magnetically controlled growing rods (MCGRs) from a multi-centered study with a minimum of 2-year follow-up. ⋯ 4.